Efficacy of Mobile Phone–Delivered Smoking Cessation Interventions for Socioeconomically Disadvantaged Individuals

Vidrine, Damon J.; Frank-Pearce, Summer G.; Vidrine, Jennifer Irvin; Tahay, Patricia D.; Marani, Salma K.; Chen, Sixia; Yuan, Ying; Cantor, Scott B.; Prokhorov, Alexander V.

doi:10.1001/jamainternmed.2018.5713

Cited by 37 publications

(23 citation statements)

References 46 publications

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“…The abstinence rate was only slightly, non-significantly higher in the OSR group, in which mobile messaging was also used, than in the TMR group. While speculative, it is possible that mobile messaging as an adjunct to an established treatment for tobacco dependence may confer minimal additional benefits, as observed in a recent pilot trial of varenicline plus text messaging versus varenicline alone [28] and a fully powered trial of nicotine replacement therapy (NRT) plus text messaging versus NRT alone [29]. While TMR seems to be more cost-effective than OSR because of the low-intensity design, the intervention costs of the two groups were similar.…”

Section: Discussionmentioning

confidence: 99%

Effects of simple active referrals of different intensities on smoking abstinence and smoking cessation services attendance: a cluster‐randomized clinical trial

Weng

Luk

Suen³

et al. 2020

Addiction

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Background and aims Proactive brief cessation advice by a lay counsellor combined with a referral to a smoking cessation service (active referral) is effective in increasing service use and quitting in community smokers. We compared the effect of two modified approaches to referrals on the cessation outcomes in community smokers. Design Three‐arm cluster‐randomized trial. Setting General community in Hong Kong. Participants Daily cigarette smokers (n = 1163; 77.7% male). Interventions Participants were randomized to receive on‐site active referral (OSR, n = 395), where lay counsellors helped participants make appointments with a smoking cessation service of their choice plus tailored reminders; mobile text messaging referral (TMR, n = 385), where participants were encouraged to use a smoking cessation service via text messages; or brief cessation advice only (control, n = 383). Measurements The primary outcome was a self‐reported 7‐day point‐prevalence abstinence at 6 months post‐treatment initiation. Secondary outcomes included 7‐day point‐prevalence abstinence at 3 and 18 months, biochemically validated abstinence, smoking reduction and the use of cessation services at 3, 6 and 18 months. Findings Using intention‐to‐treat analysis, the OSR (17.7%) and TMR (17.1%) groups had significantly higher self‐reported abstinence than the control (12.0%) group at 6 months [odds ratio (OR) for OSR versus control = 1.58, 95% confidence interval (CI) = 1.06–2.36; OR for TMR versus control = 1.52, 95% CI = 1.01–2.28; both P < 0.05]. The corresponding validated abstinence rates at 6 months were 7.6, 7.8 and 3.9% (OR for TMR versus control = 2.02, 95% CI = 1.07–3.81; OR for TMR versus control = 2.07, 95% CI = 1.10–3.92; both P < 0.05). Self‐reported and validated abstinence were similar at 18 months. OSR groups had higher rates of smoking cessation service use than the control group at all follow‐ups (all P < 0.001). The smoking reduction rates were similar in continuing smokers. Conclusions Simple active referrals (in person or via text messaging) to smoking cessation services increased abstinence rates among smokers in Hong Kong compared with general brief cessation advice. On‐site active referral increased the use of smoking cessation services compared with general brief cessation advice.

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Section: Discussionmentioning

confidence: 99%

Effects of simple active referrals of different intensities on smoking abstinence and smoking cessation services attendance: a cluster‐randomized clinical trial

Weng

Luk

Suen³

et al. 2020

Addiction

View full text Add to dashboard Cite

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“…Available models of treatment for tobacco dependence are mainly reactive and rely on a health-care practitioner to initiate treatment, 11 but novel approaches to engage lessmotivated or hard-to-reach smokers have been increasingly studied. [12][13][14] In Hong Kong, only 31% of daily smokers have ever tried to quit and most current smokers (98%) never sought help from a smoking cessation service. 15 Existing brief intervention models, such as the five-step 5As (Ask, Advise, Assess, Assist, and Arrange), mainly target smokers in clinical settings.…”

Section: Introductionmentioning

confidence: 99%

Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial

Wang

Luk

et al. 2019

The Lancet Digital Health

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Background Mobile instant messaging apps offer a modern way to deliver personalised smoking cessation support through real-time, interactive messaging (chat). In this trial, we aimed to assess the effect of chat-based instant messaging support integrated with brief interventions on smoking cessation in a cohort of smokers proactively recruited from the community. Methods In this two-arm, pragmatic, cluster-randomised controlled trial, we recruited participants aged 18 years or older who smoked at least one cigarette per day from 68 community sites in Hong Kong, China. Community sites were computer randomised (1:1) to the intervention group, in which participants received chat-based instant messaging support for 3 months, offers of referral to external smoking cessation services, and brief advice, or to the control group, in which participants received brief advice alone. The chat-based intervention included personalised behavioural support and promoted use of smoking cessation services. Masking of participants and the research team was not possible, but outcome assessors were masked to group assignment. The primary outcome was smoking abstinence validated by exhaled carbon monoxide concentrations lower than 4 parts per million and salivary cotinine concentrations lower than 10 ng/mL at 6 months after treatment initiation (3 months after the end of treatment). The primary analysis was by intention to treat and accounted for potential clustering effect by use of generalised estimating equation models. This trial is registered with ClinicalTrials.gov, number NCT03182790. Findings Between June 18 and Sept 30, 2017, 1185 participants were randomly assigned to either the intervention (n=591) or control (n=594) groups. At the 6-month follow-up (77% of participants retained), the proportion of validated abstinence was significantly higher in the intervention group than in the control group (48 [8%] of 591 in intervention vs 30 [5%] of 594 in control group, unadjusted odds ratio 1•68, 95% CI 1•03-2•74; p=0•040). Engagement in the chatbased support in the intervention group was low (17%), but strongly predicted abstinence with or without use of external smoking cessation services. Interpretation Chat-based instant messaging support integrated with brief cessation interventions increased smoking abstinence and could complement existing smoking cessation services. Funding Hong Kong Council on Smoking and Health.

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“…There was a large increase in scores from baseline to post round robin two regarding how useful Mindfulness Training was perceived to be, which was demonstrated by the statistically significant increase in the Likert score as well as the increase in total ranking score. These are important findings because there is a small amount of recent research that has found other interventions, such as mobile phones that employ text messages and proactive counselling [46] or mindfulness training [47] for smokers, might be effective for lower SES groups of smokers in the short-term but they have not listened to the voices of this target population regarding how they perceive the usefulness and feasibility of such strategies, which is likely to impact on their effectiveness in the longer-term.…”

Section: Discussionmentioning

confidence: 99%

Using a nominal group technique to approach consensus on a resilience intervention for smoking cessation in a lower socioeconomic population

et al. 2019

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BackgroundSmoking prevalence remains inequitably high for lower SES (socioeconomic status) populations. The psychosocial interactive model of resilience theorises that resilience might be ‘switched on’ in order to support and/or maintain smoking cessation for these populations. This study aimed to develop a Resilience Intervention for Smoking Cessation (RISC) through reviewing the extant literature around efficacious interventions for smoking cessation. Deliberative democracy principles were then used to understand lay perspectives regarding this potential smoking cessation program.MethodsPublic health databases were searched to find efficacious psycho-social resilience interventions in the peer-reviewed literature for smoking cessation amongst lower SES populations. Potential components for RISC were selected based on evidence within the literature for their effectiveness. We then employed the Nominal Group Technique (NGT) to create discussion and consensus on the most socially appropriate and feasible components from the perspective of smokers from low SES areas. The NGT included 16 people from a lower SES population in southern metropolitan Adelaide who indicated they were seriously contemplating quitting smoking or had recently quit. Data were collected from multiple Likert ratings and rankings of the interventions during the NGT workshop and analysed descriptively. The Wilcoxon signed-ranked test was used where appropriate. Qualitative data were collected from participant reflections and group discussion, and analysed thematically.ResultsSix smoking cessation interventions, likely to enhance resilience, were selected as potential constituents for RISC: mindfulness training; setting realistic goals; support groups; smoke free environments; mobile phone apps; and motivational interviewing. Consensus indicated that mindfulness training and setting realistic goals were the most acceptable resilience enhancing interventions, based on perceived usefulness and feasibility.ConclusionsThis research applied principles from deliberative democracy in order to illuminate lay knowledge regarding an appropriate and acceptable smoking cessation resilience program for a lower SES population. This process of collaborative and complex knowledge-generation is critically important to confront inequities as an ongoing challenge in public health, such as smoking cessation for disadvantaged groups. Further research should involve development and trial of this resilience program.

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Efficacy of Mobile Phone–Delivered Smoking Cessation Interventions for Socioeconomically Disadvantaged Individuals

Cited by 37 publications

References 46 publications

Effects of simple active referrals of different intensities on smoking abstinence and smoking cessation services attendance: a cluster‐randomized clinical trial

Effects of simple active referrals of different intensities on smoking abstinence and smoking cessation services attendance: a cluster‐randomized clinical trial

Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial

Using a nominal group technique to approach consensus on a resilience intervention for smoking cessation in a lower socioeconomic population

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